Association of penile lichen sclerosus and oncogenic human papillomavirus (HPV) infection

Abstract

Several anecdotal reports and some clinical studies have remarked on a possible causative link between genital lichen sclerosus (LS) and penile squamous cell carcinoma (SCC). A role of infection from oncogenic “high risk” HPV types in the pathogenesis of his tumor is also likely. However, it is unclear whether patients with penile LS are at higher risk for HPV infection, as the prevalence of HPV infection in patients with genital LS has seldom been evaluated and available data are relatively scant and controversial. Based on these considerations, we investigated the presence of HPV DNA in paraffin-embedded penile biopsies from 46 adult patients with penile LS. HPV DNA search was performed by a highly sensitive nested polymerase chain reaction (PCR) technique based on general GP5+/GP6+ PCR primers and consensus primers MY11/MY09. Penile smears obtained by brushing technique from an equal number of healthy males were used as a control and their evaluation is in progress. Histopathologically, all patients labelled as LS showed hyperkeratosis, atrophy of the stratum malpighii with hydropic degeneration of basal cells, pronounced edema and homogenization of the collagen in the upper dermis, and inflammatory infiltrate in the dermis. Eight specimens (17%) characterized by a band-like lymphocytic infiltrate focally separated from the dermal-epidermal junction by edema and or sclerosis, were histologically identified as early LS, 8 (17%) characterized by a band-like infiltrate separated from the epidermis by a band of dermal sclerosis with varying degrees of edema, as mature LS, and 30 (66%), showing a broad zone of dermal sclerosis with minimal or absent inflammatory infiltrate, as older LS. PCR disclosed the presence of HPV DNA in 8 cases (17.4%). Of these, 6 (2 early, 3 mature and 1 older LS) harbored HPV 16, and the remaining (2 older LS) respectively harbored HPV 18 and HPV 45. There seemed to be no relationship between histologic patterns of LS and risk for HPV infection.